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目的应用受试者工作特征曲线(Receiver operating characteristics,ROC)分析死亡诱骗受体3(Death decoy receptor 3,DcR3)对类风湿性关节炎(Rheumatoid Arthritis,RA)的诊断价值。方法用亲和素放大的酶联免疫吸附试验(ELISA)检测33例RA患者、10例硬化征患者及16例正常对照组血清可溶性DcR3浓度,分析不同组间DcR3表达的差异,以及RA患者DcR3与各临床指标的相关性。采用ROC曲线,评价DcR3对RA的诊断效能。结果 RA患者DcR3水平显著高于正常对照组(U=158.00,P<0.05),与硬化征组比较差异无统计学意义(U=121.50,P>0.05)。RA患者DcR3水平与不同疾病分期(X线分期)、性别、年龄及各临床指标相关性差异无统计学意义(P>0.05)。通过ROC曲线分析,用DcR3诊断RA的曲线下面积(Area under the ROC curve)为0.701,曲线下95%可信区间(Asymptotic95%Confidence Interval)为0.553~0.849。最佳临界点为213 pg/ml,敏感度为51.5%,特异性为81.2%;阳性似然比为2.75,阴性似然比为0.60。结论 RA患者血清可溶性DcR3高表达,对RA具有良好的诊断价值。
Objective To evaluate the diagnostic value of death decoy receptor 3 (DcR3) on rheumatoid arthritis (RA) by receiver operating characteristics (ROC). Methods Serum soluble DcR3 concentrations in 33 patients with RA, 10 patients with sclerosis and 16 normal controls were detected by enzyme-linked immunosorbent assay (ELISA), and the differences of DcR3 expression among different groups were analyzed. The levels of DcR3 Correlation with each clinical index. The ROC curve was used to evaluate the diagnostic efficacy of DcR3 for RA. Results The level of DcR3 in RA patients was significantly higher than that in normal controls (U = 158.00, P <0.05). There was no significant difference between the two groups (U = 121.50, P> 0.05). There was no significant difference in DcR3 level between RA patients and different stages (X-ray stage), sex, age and clinical indexes (P> 0.05). By ROC curve analysis, the area under the ROC curve for diagnosis of RA with DcR3 was 0.701, and the 95% confidence interval (Asymptotic95% Confidence Interval) for the curve was 0.553 to 0.849. The best cut-off point was 213 pg / ml with a sensitivity of 51.5% and a specificity of 81.2%, a positive likelihood ratio of 2.75 and a negative likelihood ratio of 0.60. Conclusion Serum soluble DcR3 is highly expressed in RA patients and has a good diagnostic value for RA.